Provider Demographics
NPI:1982721932
Name:DEBORAH HOADLEY MD LLC
Entity Type:Organization
Organization Name:DEBORAH HOADLEY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HOADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-567-0600
Mailing Address - Street 1:175 DWIGHT RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1761
Mailing Address - Country:US
Mailing Address - Phone:413-567-0600
Mailing Address - Fax:413-567-2443
Practice Address - Street 1:175 DWIGHT RD
Practice Address - Street 2:SUITE 203
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1761
Practice Address - Country:US
Practice Address - Phone:413-567-0600
Practice Address - Fax:413-567-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160506207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21762Medicare PIN